Healthcare Provider Details

I. General information

NPI: 1164249231
Provider Name (Legal Business Name): VITAL TRANSITIONS BEHAVIORAL HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11745 HAYMARKET AVE STE B
BATON ROUGE LA
70816-6010
US

IV. Provider business mailing address

11745 HAYMARKET AVE STE B
BATON ROUGE LA
70816-6010
US

V. Phone/Fax

Practice location:
  • Phone: 225-412-7913
  • Fax:
Mailing address:
  • Phone: 225-412-7913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANTWANETTE COLLINS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 225-412-7912